Methods for less invasive glenoid replacement

Abstract

The invention features a glenoid (shoulder socket) implant prosthesis, a humeral implant prosthesis, devices for implanting glenoid and humeral implant prostheses, and less invasive methods of their use for the treatment of an injured or damaged shoulder.

What is claimed is: 
     
       1. A method of treating a patient, comprising:
 providing a glenoid implant having a body, the body comprising a bearing surface, a medial surface opposite the bearing surface, a circumferential peripheral edge defined between the bearing surface and the medial surface, and a radially symmetric central peg extending from said medial surface and oriented along a central axis of the implant, the circumferential peripheral edge defining a cortical-bone-contacting surface; 
 identifying a patient having a glenoid surface; 
 reaming a cavity into the glenoid surface wholly within a boundary of a native glenoid cavity of the patient without destroying the peripheral margin of the glenoid surface; and 
 inserting the glenoid implant into the cavity, such that at least a portion of the peripheral edge of the body is inset with respect to the cavity and resides below the adjacent glenoid surface and the portion residing below the adjacent glenoid surface is circumferentially surrounded and directly supported by cortical bone of the glenoid, wherein the glenoid implant does not comprise a keel. 
 
     
     
       2. A method of treating a patient as in  claim 1 , wherein the peripheral edge is circular, and has a thickness of between about 3 mm and about 6 mm. 
     
     
       3. A method of treating a patient as in  claim 1 , wherein the peripheral edge of the body is fully inset with respect to the cavity. 
     
     
       4. A method of treating a patient as in  claim 1 , wherein the medial surface is roughened or textured. 
     
     
       5. A method of treating a patient as in  claim 4 , wherein the medial surface comprises a series of elongated grooves. 
     
     
       6. A method of treating a patient as in  claim 1 , wherein identifying a patient comprises identifying a patient having deficient glenoid bone. 
     
     
       7. A method of treating a patient as in  claim 1 , additionally comprising the step of stabilizing the implant within the cavity using the peg extending from the medial surface of the implant. 
     
     
       8. A method of treating a patient as in  claim 1 , additionally comprising the step of accessing the glenoid via a deltapectoral approach. 
     
     
       9. A method of treating a patient as in  claim 1 , additionally comprising the step of accessing the glenoid via an anterolateral approach. 
     
     
       10. A method of treating a patient as in  claim 1 , additionally comprising the step of accessing the glenoid via an incision no more than 9 cm in length. 
     
     
       11. A method of treating a patient as in  claim 1 , wherein the reaming a cavity step is accomplished while leaving the inferior capsule intact. 
     
     
       12. A method of treating a patient as in  claim 1 , wherein the reaming a cavity step is accomplished while leaving the peripheral cortex intact. 
     
     
       13. A method of treating a patient as in  claim 1 , wherein the reaming a cavity step is accomplished using a power drill having a 90 degree bend. 
     
     
       14. A method of treating a patient, comprising:
 providing a glenoid implant having a body, the body comprising a bearing surface, a medial surface opposite the bearing surface, a circumferential peripheral edge defined between the bearing surface and the medial surface, and a radially symmetric central peg extending from said medial surface and oriented along a central axis of the implant, the circumferential peripheral edge defining a cortical-bone-contacting surface; 
 identifying a patient having a glenoid surface; 
 reaming a cavity into the glenoid surface wholly within a boundary of a native glenoid cavity of the patient without destroying a peripheral margin of the glenoid surface; and 
 inserting the glenoid implant into the cavity, such that at least a portion of the peripheral edge of the body is inset with respect to the cavity and resides below the adjacent glenoid surface and the portion residing below the adjacent glenoid surface lies directly adjacent to and is circumferentially surrounded and supported by cortical bone of the glenoid, wherein the glenoid implant does not comprise a keel. 
 
     
     
       15. The method of treating a patient as in  claim 14 , wherein a backside surface of the glenoid implant is flat. 
     
     
       16. The method of treating a patient as in  claim 14 , wherein the central peg has a length of less than about 10 mm. 
     
     
       17. The method of treating a patient as in  claim 14 , wherein the body comprises a cylindrical peripheral edge. 
     
     
       18. The method of treating a patient as in  claim 14 , wherein the body comprises an ovoid peripheral edge. 
     
     
       19. The method of treating a patient as in  claim 14 , wherein the medial surface of the glenoid implant comprises a roughened or textured surface.